Pathophysiology: Superior vena cava syndrome (SVCS) or superior vena cava obstruction (SVCO) is caused by gradual compression/obstruction of thesuperior vena cavavein by disease, growth or malignancies of any of the structures which surround it. However presently in 90% of the cases, this syndrome is associated with malignancy and in 80% of these cases, bronchogenic carcinoma is the cause. Occurrence of symptoms is gradual and therefore it is found that the diagnosis is often delayed till symptoms become severe due to significant obstruction. The SVC is particularly susceptible to compression because it is thin-walled, has low pressure of blood flowing through it and rigid structures surrounding it. The most common cause is now bronchogenic carcinoma and 15% of the cases are cased by lymphoma. (1,2)
Symptoms: Swelling around the eyes, face, neck, trunk and arms SOB Decreased alterness Dizziness Fainting Headache Reddish Palms, face, cheeks, mucus membranes Vision Changes "fullness" of the head or ear
Super_Vena_xray.png
Interventions and Drug Therapy: Primary nursing intervention: picking up on the symptoms early! Radiation and chemotherapy if a tumor is the cause Surgery to remove the tumor or a stent may be used in some cases Diuretics or steroids may be used to relieve swelling Infections are treated with appropriate antibiotics Thrombosis are treated with thrombolytic drugs
Heller, MD, MHA, Virginia Mason Medical Center. Seattle, Washington, Jacob L., and David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc. "SVC Obstruction." PubMed Health. National Center for Biotechnology Information, U.S. National Library of Medicine, 23 May 2011. Web. 2012. <http://ncbi.nlm.nih.gov>. SAMPHAO S, EREMIN J, EREMIN O. Oncological emergencies: clinical importance and principles of management. European Journal of Cancer Care [serial online]. November 2010; 19(6):707-713. Available from: Health Source: Nursing/Academic Edition, Ipswich, MA. Accessed January 18, 2012.
Group One - Oncologic Emergencies Superior Vena Cava Syndrome
Pathophysiology:
Superior vena cava syndrome (SVCS) or superior vena cava obstruction (SVCO) is caused by gradual compression/obstruction of thesuperior vena cavavein by disease, growth or malignancies of any of the structures which surround it. However presently in 90% of the cases, this syndrome is associated with malignancy and in 80% of these cases, bronchogenic carcinoma is the cause.
Occurrence of symptoms is gradual and therefore it is found that the diagnosis is often delayed till symptoms become severe due to significant obstruction. The SVC is particularly susceptible to compression because it is thin-walled, has low pressure of blood flowing through it and rigid structures surrounding it. The most common cause is now bronchogenic carcinoma and 15% of the cases are cased by lymphoma. (1,2)
Symptoms:
Swelling around the eyes, face, neck, trunk and arms
SOB
Decreased alterness
Dizziness
Fainting
Headache
Reddish Palms, face, cheeks, mucus membranes
Vision Changes
"fullness" of the head or ear
Interventions and Drug Therapy:
Primary nursing intervention: picking up on the symptoms early!
Radiation and chemotherapy if a tumor is the cause
Surgery to remove the tumor or a stent may be used in some cases
Diuretics or steroids may be used to relieve swelling
Infections are treated with appropriate antibiotics
Thrombosis are treated with thrombolytic drugs
Journal Articles
Samphao S., Eremin J.M. & Eremin O. [2010] European Journal of Cancer Care 19, 707-713 Oncological emergencies: clinical importance and principles of management
http://prox1.harpercollege.edu:2052/ehost/pdfviewer/pdfviewer?vid=4&hid=18&sid=c193b324-857f-4ac6-8af6-065dc0163aab%40sessionmgr4
Websites/Resources
National Cancer Institute at the National Institutes of Health
http://www.cancer.gov/cancertopics/pdq/supportivecare/cardiopulmonary/Patient/page5
BMJ Evidence Centre
http://bestpractice.bmj.com/best-practice/monograph/848/treatment/step-by-step.html
University of Massachusetts Medical School. Beth Israel Deaconess Medical Center. Sejal Patel
http://eradiology.bidmc.harvard.edu/LearningLab/cardio/Patel.pdf
References
1- http://mediconweb.com/heart-2/superior-vena-cava-syndrome/
2-http://www.oncolink.org/resources/article.cfm?c=16&s=46&ss=205&id=893
Heller, MD, MHA, Virginia Mason Medical Center. Seattle, Washington, Jacob L., and David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc. "SVC Obstruction." PubMed Health. National Center for Biotechnology Information, U.S. National Library of Medicine, 23 May 2011. Web. 2012. <http://ncbi.nlm.nih.gov>.
SAMPHAO S, EREMIN J, EREMIN O. Oncological emergencies: clinical importance and principles of management. European Journal of Cancer Care [serial online]. November 2010; 19(6):707-713. Available from: Health Source: Nursing/Academic Edition, Ipswich, MA. Accessed January 18, 2012.